Topics Related to Division of Health Benefits

Hospital at Home Program Re-Launch: NC Medicaid will cover the Acute Hospital at Home Program starting Nov. 1, 2023. NOTE: This Bulletin was revised on April 2, 2024 to correct an error. In the original version, published Sept. 27, 2023, it was stated that the Hospital at Home Program had a previous end date of March 31, 2021. Prior to relaunch, the previous end date was March 31, 2022, as corrected and explained below.
Effective Oct. 1, 2023, copays will no longer be required for adult vaccines and vaccine administration.
Cards are only allowed to be used exclusively for the member’s individual needs.
Effective with date of service May 26, 2023, NC Medicaid covers risperidone extended-release injectable suspension, for subcutaneous use (Uzedy)
Effective with date of service June 2, 2023, NC Medicaid covers epcoritamab-bysp injection, for subcutaneous use (Epkinly)
Additional clarification on implementation
Clinical Coverage Policy 8A, Enhanced Mental Health and Substance Abuse Services and 8C, Outpatient Behavioral Health Services
More than 600,000 people will gain access to quality care.
Mitigation process for any adverse impact for nursing facilities if a PASRR authorization is delayed.
Near Relatives and Legally Responsible Persons May Deliver Skilled Nursing Service to a PDN-eligible Beneficiary.